| NPI | 1184946550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 431653) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 297200) |
| Enumeration Date | 2010-02-25 |
| Last Update Date | 2021-04-23 |